COVID-19 and Pregnancy

The SARS-CoV-2 pandemic has emerged as an unprecedented challenge to the current medical practice, including obstetrics. Being an acute situation, there is limited experience of the impact of COVID-19 in pregnancy. Various management protocols are being evaluated and modified frequently to address key concerns of maternal and neonatal health. Pregnancy is a unique bundle of two lives, and the physiological adaptation to the dual life adds to the uniqueness. The effect of COVID- 19 and its treatment on pregnancy (mother and fetus) and vice-versa, is a common quest for all pathologies. The other concerns are vertical and horizontal transmission in antepartum, intrapartum, and postpartum periods, respectively. The immunosuppression as a part of physiological changes during pregnancy apparently raises apprehension of higher risk of viral infection or probability of severity of infection during pregnancy. The same has also been observed with previous virus infections in history like severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), etc., although available literature suggests that the risk of developing COVID-19 for pregnant women is not similar to the non-pregnant adult population. The small risk of developing a serious condition during pregnancy is inevitable, and the contagiousness of the virus is a major concern for the neonate and attending family. Some overlapping features of complicated pregnancy with severe COVID-19 require attention. Social distancing, anxiety, and psychological stress need to be kept in mind. There is an impact of financial stress on family; domestic violence can also not be undermined during this crisis period. Access to health facilities may also be affected in developing countries due to the lockdowns, quarantine of pregnant women, caretakers, or health care workers (HCW), etc. The aerosol production during the intrapartum phase is challenging for both vaginal and abdominal routes of delivery, but the management of sudden catastrophic, life-threatening conditions associated with pregnancy can be a real threat for the team of health care workers. It is still early to comment on the long-term effects of the viral infection on the foetus, especially the exposure during the rapid embryogenesis period.

Keywords: ACOG advisory, Aerosols, Aerosol Generating Procedure (AGP), Corona Virus Disease, COVID-19, COVID and Preeclampsia, COVID Pneumonia, COVID-19 Transmission, Droplet Infection, Infant Mother Dyad MERS, Pandemic, PPE, N95, Nasopharyngeal Swab, Respirator, RT-PCR, SARS-CoV-1, SARS-CoV-2, Surface Fomites, Surgical Mask, Temporary Separation, Vertical transmission in COVID-19.